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Biomedical subjects

K Yokoi

Publications and source records attributed to K Yokoi.

At least 109 records · Page 6Linked to original sources

[An elderly patient with gastric cancer surviving long after chemotherapy using UFT alone].

A 77-year-old patient with low activity of daily life (ADL) having advanced gastric cancer was treated by low dose UFT alone (300 mg/day) for more than 11 years. He survived, and neither remarkable progression nor metastasis of the gastric cancer has been observed in more than an 11-year hospital-free survival period. He has maintained his low ADL, and no side effects of the chemotherapy were observed. This case is probably rare, but suggestive in the choice of treatment for elderly patients.

Activities of Daily Living↗

[Diagnosis of pleural dissemination lung cancer by thin-section CT--a prospective study].

In this prospective study, thin-section CT was used to diagnose pleural dissemination in patients with pulmonary adenocarcinomas in which the primary lesion was found to be adjacent to the pleural surface by conventional CT. The subjects were 32 patients (25) who had undergone resection and 7 who had not with pulmonary adenocarcinoma without pleural effusion from among the 136 patients with pulmonary adenocarcinoma examined at our institution over 3 years. Thin-section CT images of three regions were obtained, and these included the pleural surface adjacent to the lesion, the minor fissure, and the diaphragmatic dome. Histopathological examination revealed pleural dissemination in 12 patients (5 who had undergone resection and who had not), in 2 of whom a diagnosis could not be made preoperatively. Pleural dissemination was diagnosed by CT in 12 patients; there were 2 false positives. In 6 patients who did not undergo resection, cancerous cells were found in fluid obtained by percutaneous pleural lavage, and mediastinal lymph node metastases or distant metastases were also detected. The diagnostic rate of CT was as follows interlobar space. 100% (7/7); mediastinum, 75% (3/4); diaphragm, 71% (5/7); and chest wall, 57% (4/7). In the patients who underwent resection, sensitivity was 100% for the interlobar space, but it was 0% to 33% for other pleural surfaces.

Adenocarcinoma↗

Presence of human T-lymphotropic virus type II-related genes in DNA of peripheral leukocytes from patients with autoimmune thyroid diseases.

No etiologic role of human T-lymphotropic virus type II (HTLV-II) in any disease is yet known. The present study showed a high incidence of HTLV-II proviral DNA fragments in DNA of peripheral blood leukocytes from patients with autoimmune thyroid diseases. Using primers for the pol and tax regions of HTLV-II proviral DNA, amplified DNA fragments were demonstrated in 51.5% of the patients with Hashimoto's thyroiditis and in 11.8% of those with Graves' disease examined, but in only 1.9% of the disease controls and 1.0% of healthy individuals. These amplified DNA fragments hybridized with each of the inner probes. The nucleotide sequences of the DNA fragments of the pol and tax regions showed high homology with those of the prototype of HTLV-II. No antibodies for HTLV-II could, however, be detected in the patients examined. Because of the absence of its antibody, HTLV-II infection was not confirmed in these patients, but the presence of HTLV-II proviral DNA or its related DNA at high frequency suggests a relationship of HTLV-II with the development of autoimmune thyroid diseases.

Adult↗

Mitochondrial encephalomyopathy with autosomal dominant inheritance: a clinical and genetic entity of mitochondrial diseases.

We report a Japanese family with chronic progressive external ophthalmoplegia (CPEO) with autosomal dominant inheritance, and review 54 reported CPEO patients in seven families (including the present family) with autosomal dominant inheritance and mtDNA deletions in the skeletal muscle. Mean age at onset in the CPEO was 26 years, which is older than that in published solitary cases. In addition to blepharoptosis and external opthalmoplegia, proximal muscle atrophy and weakness were found in 62%, hearing loss in 25%, and ataxia in 17% of the patients. Retinal degeneration was not found, and cardiac involvement was very rare. mtDNA deletions in the muscle were multiple and large scale, and all such deletions were located in the non-D-loop region. Autosomal dominant CPEO has unique clinical features which differ from those of solitary CPEO, and is associated with multiple large-scale mtDNA deletions. Thus, autosomal dominant CPEO can be considered a clinical and genetic entity of mitochondrial diseases.

Base Sequence↗

Graves' disease in HTLV-I carriers.

Three carriers of human T-lymphotropic virus type I (HTLV-I) with Graves' disease are reported. All three cases were complicated with uveitis, and one also showed chronic arthropathy. Anti-HLTV-I antibody was found in the serum by the particle agglutination method and western blotting, and HTLV-I proviral DNA was detected in peripheral lymphocytes by the polymerase chain reaction and Southern blotting. HTLV-I is a causal agent of adult T-cell leukemia and HTLV-I associated myelopathy/tropical spastic paraparesis, and is believed to be related to the pathogenesis of diseases such as chronic arthropathy, uveitis, chronic bronchoalveolitis, and Sjögren's syndrome. On the other hand, retrovirus infection is considered to cause autoimmune diseases. Thus, the pathogenesis of Graves' disease in the present patients might be associated with HTLV-I infection.

Aged↗

Iron, zinc, and copper levels in different tissues of clinically vitamin A-deficient rats.

To clarify the effect of vitamin A deficiency on iron, zinc, and copper status in different tissues, three groups of rats were fed two types of synthetic diets for 52 d. Group one, which was fed a vitamin A-deficient diet, showed severe signs of vitamin A deficiency. Groups two (fed restricted amount, pair-fed with group one), and three (fed diet ad libitum) were fed a control diet. After said period of feeding, iron, zinc, and copper were measured in different tissues. Significant changes observed when the groups were compared are summarized below: 1. Iron and copper in testes were increased significantly, whereas zinc was strikingly decreased in group one when compared with the other groups; 2. Copper (in lung and kidney) and iron (in the spleen) were increased significantly in group one compared with the other groups; 3. In the liver, iron, zinc, and copper were significantly different between group one and group two; 4. In muscle, iron was significantly higher in group one than group two; 5. In tibia and blood, iron levels (but not zinc and copper) in groups one and two were significantly higher than group three. These results suggest that vitamin A deficiency affects iron, zinc, and copper status in rats.

Animals↗

Water content in experimental dentine primers to minimize the contraction gap width of a light-cured resin composite.

OBJECTIVES: The effect of water content in experimental dentine primers consisting of an aqueous solution of either glyceryl methacrylate (GM) or hydroxyethyl methacrylate (HEMA), and in experimental self-etching dentine primers composed of methacryloxyethyl hydrogen phenyl phosphate (Phenyl-P), was evaluated by measuring the wall-to-wall polymerization contraction gap width of a commercial light-activated resin composite filled in a cylindrical dentine cavity prepared in an extracted human molar. METHODS: A commercial light-cured dentine bonding agent was applied to the cavity after cleaning with EDTA and priming with either GM or HEMA, or after self-etching priming by Phenyl-P diluted in either GM or HEMA solution. RESULTS: In the GM and HEMA solutions, the gap width was minimized when the water content was 65 wt% even though gap formation could not be prevented by HEMA solution. With the self-etching dentine primers, gaps could not be observed under the light microscope with 16 wt% Phenyl-P diluted in 35 wt% GM or HEMA or with 20 wt% Phenyl-P diluted in 20 wt% GM or HEMA. CONCLUSION: The water content in both the experimental dentine primers and the self-etching dentine primers which yielded the minimum contraction gap width for the resin composite in the dentine cavity was approximately 60 wt%.

Composite Resins↗

Endovascular papillary angioendothelioma-like tumour associated with lymphoedema.

A case of endovascular papillary angioendothelioma-like tumour associated with lymphoedema is described. Microscopically, the tumour was composed of anastomosing vascular channels, some of which contained papillary projections, producing tuft-like or glomeruloid appearances. The dermis also showed moderate lymphoedema and lymphocytic infiltrate. The tumour resembled endovascular papillary angioendothelioma but also had several features that differed from typical examples: occurrence in an old patient and less prominent endothelial hobnail features and lymphocytic infiltrate. Three types of proliferating cells were observed: 1 mature flattened endothelial cells, which were strongly positive for endothelial markers (factor VIII-related antigen, CD31, CD34) and bound ulex europaeus agglutinin 1;2 immature endothelial cells with round nuclei and vacuolated or pale cytoplasm, which were strongly positive for CD31 and muscle-specific actin (HHF35) and focally positive for other endothelial markers; and 3 stromal spindle cells in papillary or glomeruloid areas, which were positive for vimentin, HHF35, and alpha-smooth muscle actin but negative for desmin. The tumour was diploid by flow cytometry. The patient was well without disease twelve months after the excision. We postulate that this tumour was caused by circulatory disturbance, namely lymphoedema associated with syringomyelia and a Charcot's joint.

Aged↗

Increased serum IgE level and interleukin-4 release from cultured lymphocytes from a patient with adult onset Still's disease.

OBJECTIVE: To evaluate the relationship between high serum levels of IgE and the release of interleukin-4 (IL-4) from cultured lymphocytes of a patient with adult onset Still's disease. METHODS: IL-4 concentrations in plasma and culture from inactivated peripheral blood mononuclear cells were assessed by enzyme immunoassay during febrile episodes and remission. RESULTS: A high level of IL-4 was detected by enzyme immunoassay in the peripheral blood mononuclear cells cultured from the patient. These seemed to correspond with a febrile episode and a high serum IgE concentration. CONCLUSION: Increased serum IgE concentrations during a febrile episode are rare in patients with adult onset Still's disease, but the relationship between the high levels of serum IgE and IL-4 in cultured lymphocytes may provide clues to pathogenesis of the condition.

Adult↗

Cholesterol emboli following percutaneous transluminal coronary angioplasty as speculated by toe skin biopsy.

A 55-year-old man required hemodialysis for acute renal failure 3 days after repeat percutaneous transluminal coronary angioplasty (PTCA). Bilateral acrocyanosis and necrotic lesions of the toes occurred 10 days after PTCA. Skin biopsy samples revealed needle-shaped cholesterol crystals of the intraluminal clefts in his small arteries. He was diagnosed with cholesterol emboli presenting as blue toe syndrome. The conditions improved with anticoagulation and vasodilation, but improvement in renal function was temporary. He later required maintenance hemodialysis. Cholesterol emboli following PTCA are life threatening because they are difficult to diagnose and can cause severe complications.

Angioplasty, Balloon, Coronary↗

[Clinical evaluation of the small solitary pulmonary nodule].

The diagnostic process for small solitary pulmonary nodules was retrospectively analyzed. Three hundred and forty-three patients, each with a solitary pulmonary lesion of less than 3 cm on chest radiography, were evaluated. The patients were seen at our hospital between September 1986 and December 1993. They consisted of 138 with malignant diseases (114 with lung cancer and 24 with metastatic tumors), and 205 with benign diseases. There were 146 patients (71%) with benign lesions of less than 2 cm. The diagnosis in 118 patients (86%) with malignant disease was made by lung biopsy. Of these 118 patients, 19 underwent biopsy of the lung through a thoracoscope or open lung biopsy via a thoracotomy. Benign diseases were diagnosed in 167 patients (81%) by various laboratory tests and imaging techniques, including chest radiography. Thinsection CT was done in 132 patients. In 72 of these 132 patients (16 with lung cancer, 23 with metastatic tumors, and 33 with benign tumors), a judgement regarding whether the lesion was malignant or not could not be made. Therefore, open lung biopsy was done in 5 patients. Twenty-four patients were only observed, 43 underwent biopsy, and 35 underwent surgery. A decision tree needs to be established to select therapeutic options for management of patients whose diagnoses remain indeterminate even after thin-section CT. Formulation of a decision tree based not only on clinical findings but also on the results of diagnostic imaging is necessary to improve clinical decision making regarding small solitary pulmonary nodules.

Aged↗

Serum inhibin levels in normal men and men with idiopathic infertility.

In vitro studies have shown that the Sertoli cell is the primary source of inhibin in the male. To assess the regulation of inhibin production we measured serum inhibin, FSH, LH and testosterone in 21 normal men and 104 men with various testicular disorders resulting in infertility. The infertile men were subdivided into groups on the basis of their mean sperm count, FSH and LH levels. The mean serum concentrations of inhibin in the normal men were 602 +/- 29 U/L and were significantly decreased in those groups with severe oligozoospermia (p < 0.01) or azoospermia (p < 0.01; p < 0.001). The FSH concentrations correlated inversely with serum inhibin concentrations (p < 0.001) in azoospermic men. Azoospermic men with high FSH had significantly lower inhibin and testosterone levels when compared with normal men (p < 0.01; p < 0.001). Serum FSH concentrations were significantly increased in azoospermic men (p < 0.001). Our present results of serum concentrations of inhibin correlating inversely with those of FSH levels suggest that measurement of inhibin may be a useful circulating marker of Sertoli cell function.

Adult↗

The effect of varicocelectomy on testicular volume in infertile patients with varicoceles.

The presence of a varicocele has been associated with decrease in testicular volume both in adult and pediatric patients. However, a study on the effect of varicocelectomy on testicular volume in the adult varicocele patient has never been reported. We determined the testicular volume before and after varicocelectomy in 52 patients with varicocele. A significant increase in testicular volume with the right side showing a greater increase was observed (p < 0.05). No greater increase in testicular volume was noted among the patients who achieved a pregnancy with their spouses. In addition, the age of the patient did not correlate with the observed change in testicular volume. These results suggest that varicocele is clearly related to decreased testicular volume and that varicocelectomy can increase bilateral testis volume resulting in improved testicular function.

Adult↗

Successful in vitro fertilization and pregnancy by the micromanipulation with sperm from efferent duct retrieved by micropuncture technique in a patient with congenital absence of the vas deferens.

A case of successful in vitro microfertilization and pregnancy of 30-year-old woman with sperm from efferent duct retrieved by a micropuncture technique combined with perivascular nerve stimulation from a patient with congenital absence of the vas deferens is reported. Treatment of couples involving men with surgically unreconstructible vasal obstruction is now possible. Our experience indicates that sperm from the efferent duct retrieved by this new technique, when combined with assisted reproductive technologies, permit fertilization and subsequent pregnancy for the men with surgically irreparable vasal obstruction.

Adult↗

[Thymic Hodgkin's disease with cystic variants: a case report].

We report an unusual case of thymic Hodgkin's disease with cystic variants. The patient complained of nodules in his neck. Chest radiographs showed a mass with cystic lesions in the anterior mediastinum. Although Hodgkin's disease was suspected from pathologic examination of biopsy specimens of the neck nodules, the mediastinal and neck masses could not be precisely diagnosed until a median sternotomy was done. The surgically excised mediastinal masses revealed thymic Hodgkin's disease with cystic lesions. The patient has done well after chemotherapy and radiotherapy. Thymic Hodgkin's disease with cystic variants is very rare and only seventeen cases of this disease have been reported.

Adult↗

A case of sex reversal syndrome with sex-determining region (XX male).

We examined a 32-year-old man with a 4-year history of infertility. The man's sex life, male hair pattern, and penis were normal, and he had no history of erection problems. Left and right testicular volumes were 2 ml and 3 ml, respectively. Semen analysis showed no sperm. The endocrine panel revealed increased serum luteinizing hormone and follicle-stimulating hormone levels, and a normal serum testosterone level. A testicular biopsy demonstrated that both Leydig cell and Sertoli cell hyperplasia were present, and that no germ cells were found in the tubules. A chromosome analysis done on the peripheral blood lymphocytes revealed a karyotype of 46, XX. We identified the sex-determining region, Y, by polymerase chain reaction using Y-specific probes in this patient. The diagnosis was XX male.

Adult↗

A simple and compressive splint for palmar skin grafting in young children with burns.

A simple, compressive, and easily applied splint which is suitable even for fearful and uncooperative patients after skin grafting for paediatric deep palmar burns is described. The hand, including the wrist and the forearm, is inserted between the palmar and dorsal plates of the splint and thus compression and immobilization act to decrease flexion contracture and dysfunction of the digits. Compression can be easily controlled by the use of leather bands.

Burns↗